Midwives urge black and Asian women who have felt ‘ignored and invisible’ to be part of huge maternity review

Sabah Ghaffar and Gemma Poole
By Anna Whittaker, Local Democracy Reporter

Midwives working at Nottingham’s under-pressure maternity units have spoken out about the impact of the independent Ockenden review on services, saying they welcome its scrutiny as a “breath of fresh air”.

Maternity departments at the Queen’s Medical Centre and City Hospital are currently rated ‘inadequate’ by the healthcare watchdog.

The services at Nottingham University Hospitals Trust (NUH) are also undergoing an independent review by midwife and healthcare expert Donna Ockenden.

She is examining a number of previous baby deaths and injuries at the units and warned the trust last month black and Asian women in particular feel a  “deepened mistrust” of the service.

The Local Democracy Reporting Service met Nottingham midwives Gemma Poole and Sabah Ghaffar, who spoke about their own experiences.

Mrs Poole also has her own business, The Essential Baby Company, which offers antenatal education, training and projects focused on Black maternal health.

Mrs Poole and her midwife colleagues are now working with Donna Ockenden as part of a new partnership to bring more Black and Asian voices into the maternity review in Nottingham.

Many more white families have come forward to speak to the review team, compared to response rates from Black and Asian families.

Last week also marked the first Black Baby Loss Awareness Week.

Gemma Poole

Black babies have a 50 per cent increased risk of neonatal death and a 121 per cent increased risk of stillbirth, compared with children who are white.

And a Parliamentary report into Black Maternal Health found there is a higher relative risk of death for almost all ethnic groups compared to white women.

It comes as Ms Ockenden has sent a letter to NUH Chief Executive Anthony May, explaining her concerns with the way the trust treats black and Asian women within its maternity services.

The letter says the trust has failed to communicate properly with black and Asian women and failed to appreciate cultural sensitivities.

In response, NUH said a new task force, made up of midwives, doctors, researchers, advocates and black and Asian staff and families has been set up to address concerns.

Mrs Poole said: “We have seen women’s trust and willingness to come forward to speak about their experiences at NUH significantly decrease in the last six months.

“I think it’s a combination of the Black Maternal Health report, the fact that baby loss statistics are getting worse, and the fact that families don’t see change at NUH.

“They lack confidence in the service and you can only reverse that with action, not words.”

Mrs Poole said midwives on the ground are seeing women come to the trust to have their babies who are “absolutely petrified”.

She said: “Women are taking everybody else’s experiences into that labour room with them.

“Some of them say they thought they were never going to come home.”

Mrs Poole adds that Black and Asian women can feel “ignored and invisible” when they are in the care of maternity services.

But she stressed the importance of parents and families coming forward to be part of the review.

She said: “Donna’s review – it’s a breath of fresh air.

“I can’t tell you how pleased and how special it is to have an opportunity not only in Nottingham but across the country.

“I’m concerned that women will think that this is another inquiry which isn’t going anywhere.

“I can put my hand on my heart and I promise that the maternity services will never ever, ever look the same as they do today.

“Donna is here to listen and to put rapid improvements in place.”

On May 19, an event was held at City Hospital to mark life after baby loss as part of Black Baby Loss Awareness Week.

Kelly Powell-Williams, who works for NUH as a urology oncology nurse, attended the event and explained how she had three rounds of IVF and three miscarriages.

She found out she was pregnant with twins in November 2022, but sadly lost one baby at eight weeks. She is now 27 weeks pregnant.

Kelly Powell-Williams

She said: “Representation is really important. When I was first looking for fertility treatments in Nottingham, there were no black or brown women on the website. There was also no information about what happens when you have a miscarriage.

“I had 18 months of IVF treatment and three miscarriages.

“I had a confirmed twin pregnancy last year but I lost one of the twins at eight weeks. I’ve got a surviving pregnancy remaining.

“I don’t think I will feel completely reassured until my baby is here, given the statistics about the disparities around black maternal health.

“It’s a constant worry.”

She said there’s a need for more information about miscarriage and the support that is available to women.

But she added: “I just want to feel that when I am in labour, I am going to have the same care needs met as the person in the next bed.”

Midwife Sabah Ghaffar, told the Local Democracy Reporting Service that there are many barriers to some communities in Nottingham accessing services such as bereavement or psychological care.

She said: “Women feel like they won’t be heard because of things like language barriers or cultural barriers.

“I think it just comes down to understanding and awareness. It’s about respecting women from cultures or religions that have those requirements and looking at ways we can personalise care around them.

“A lot of these women have come from different countries as well and their first language isn’t English.

“So when they’re accessing the maternity services, there’s just already a huge barrier.”

She added that it can be “frustrating” for midwives on the shop floor, as many of the changes are directed from a higher level.

Donna Ockenden, the chair of the maternity review at NUH

Sabah added: “I think there’s a positive vibe going on within maternity services at the moment, there is a focus to get women’s voices out there.

“We want to encourage women from South Asian backgrounds, from Afro Caribbean backgrounds, Black, South Asian, and brown-skinned women to come forward because this is for you.”

Michelle Rhodes, Chief Nurse at Nottingham University Hospitals NHS Trust, said: “Listening to women and families who use our maternity services is crucial to making the improvements that we all want to see. We know that more must be done to ensure that the voices of women from all the communities we serve are heard and we welcome the feedback from Donna Ockenden and her team.

“Women and families can be assured that the feedback and learning that is shared with us throughout the review will be used to make changes to our maternity services immediately.”

The Ockenden review team can be contacted on [email protected].

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